Chacón Jesús, Sanz Iziar, Rubio María Dolores, de la Morena María Luisa, Díaz Esperanza, Mateos María Luisa, Baquero Fernando
Servicios de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, España.
Enferm Infecc Microbiol Clin. 2007 May;25(5):311-6. doi: 10.1157/13102266.
This study investigates the relationship between various human papillomavirus (HPV) genotypes and the results of cytological and histological analysis of cervical samples using two complementary assays for HPV detection (hybrid capture and PCR). We studied the impact of HPV genotype on the presence of pre-cancerous cervical lesions and cervical cancer, as well as the association between HPV viral load and the presence of high-risk HPV as determined by PCR.
A total of 272 women were studied. Most of them presented cellular alterations consistent with cervical lesions due to HPV and all had high-risk HPV as detected by hybrid capture testing. Histological studies were undertaken, and HPV genotyping by PCR based on microarrays was performed.
HPV-DNA was not detected or genotypes could not be identified by PCR in 22.06% of the patients. Genotype 16 and/or 18 was detected in 33% of 212 patients. Mixed infections with several genotypes were found in 25% of patients. The histological lesions associated with the various genotypes were as follows: genotype 16 and/or 18. were detected in 55.73% of the 61 patients with H-SIL and cancer, whereas these genotypes were detected in only 7.9% and 22% of women with ASCUS and L-SIL (P < 0.05). Viral load was less than 3 pg/mL in 12.13% of the women studied. In this group of patients, high-risk HPV was present in 39.39%. In the group of patients who had a viral load greater than 3 pg/mL, high risk-HPV was detected in 77.4% (P < 0.05).
Genotypes 16 and/or 18 were detected in most patients with a diagnosis of H-SIL. Other high-risk-HPV genotypes were much less prevalent. Hybrid capture testing is a useful screening test. PCR was effective for identifying genotypes 16 and 18. Histological and cytological findings in cervical samples should be interpreted together with high-risk HPV detection.
本研究使用两种互补的人乳头瘤病毒（HPV）检测方法（杂交捕获法和聚合酶链反应法），调查了各种HPV基因型与宫颈样本细胞学和组织学分析结果之间的关系。我们研究了HPV基因型对癌前宫颈病变和宫颈癌存在情况的影响，以及通过聚合酶链反应法测定的HPV病毒载量与高危型HPV存在情况之间的关联。
共对272名女性进行了研究。她们中的大多数呈现出与HPV引起的宫颈病变一致的细胞改变，并且通过杂交捕获检测均检测出高危型HPV。进行了组织学研究，并基于微阵列通过聚合酶链反应法进行了HPV基因分型。
22.06%的患者未检测到HPV-DNA或无法通过聚合酶链反应法鉴定基因型。在212名患者中，33%检测到16型和/或18型。25%的患者发现有多种基因型的混合感染。与各种基因型相关的组织学病变如下：在61例高级别鳞状上皮内病变（H-SIL）和癌症患者中，55.73%检测到16型和/或18型，而在非典型鳞状细胞（ASCUS）和低级别鳞状上皮内病变（L-SIL）女性中，仅7.9%和22%检测到这些基因型（P<0.05）。12.13%的研究女性病毒载量低于3 pg/mL。在这组患者中，39.39%存在高危型HPV。在病毒载量大于3 pg/mL的患者组中，77.4%检测到高危型HPV（P<0.05）。
大多数诊断为H-SIL的患者检测到16型和/或18型。其他高危型HPV基因型的流行率要低得多。杂交捕获检测是一种有用的筛查试验。聚合酶链反应法对于鉴定16型和18型有效。宫颈样本的组织学和细胞学结果应与高危型HPV检测结果一起解读。
